Acute and Chronic Pain

In the past few decades, there have been many developments in the field of pain management. One of the most significant in this area is the emergence of millennium medicine, which deploys cutting-edge technology and innovative techniques to alleviate pain.

Physicians’ Back Institute approaches pain management and physical therapy via Millenium Medicine.

In their San Francisco pain management practice, Doctors Irène and Robert Minkowsky diagnose and provide treatment for both acute and chronic pain and related medical conditions. An acute pain problem develops suddenly and may be disabling. Chronic pain usually develops more slowly and is persistent. Chronic pain is defined as pain that persists for longer than 3-6 months. According to the NIH, in a 2012 survey, 25.3 million adults (11.2%) had chronic pain every day for the previous 3 months (source).

It may also begin with an acute injury that does not resolve and becomes progressively more widespread. Different regions of the body may become involved, often at a distance from the site of the initial complaint. The chronic pain signals keep firing in the nervous system. Similar to a forest fire, the spread of the pain becomes difficult to contain. Chronic pain is defined as pain that persists for longer than 3-6 months. According to the NIH, in a 2012 survey, 25.3 million adults (11.2%) had chronic pain every day for the previous 3 months.

Chronic pain is a systemic total body problem that over time spreads to the emotional health and perspective of the patient. Only a global approach stands any chance of success. Millennium medicine describes the latest and most advanced medical treatments available today. It encompasses a wide range of technologies and therapies that are specifically designed to target and manage pain. In vogue today as part of millennium medicine is the treatment of chronic pain with nerve blocks, radio frequency ablation, rhizotomy and spinal cord stimulation. In the experience of the doctors at the Physicians’ Back Institute, these medical approaches are only band-aids on a systemic problem and rarely lead to long term good care and resolution of symptoms.

Doctors Irène & Robert Minkowsky are SF-based chronic pain doctors and are experts in diagnosing and treating complex medical issues that cause pain and result in loss of function or even employment. They base their diagnosis based on clinical examination complemented by radiographic studies. They personalize treatment plans according to each patient’s unique needs, addressing the causes as well as the resulting symptoms.

The Role of Manipulation

The musculoskeletal system is very complex and includes joints, ligaments, muscles, tendons nerves and blood vessels, all surrounded by fascia. All elements must be addressed for the successful resolution of a problem.

As San Francisco pain management specialists, the Minkowskys frequently use osteopathic approaches and manipulation to treat their patients. This includes osteopathic manual therapy (OMT), visceral and craniosacral manipulation. Manipulation has been shown to have a direct effect on the nervous system (J Man Manip Ther. 2010 Dec; 18(4): 181–190). This approach has the benefit of trying to reset the source of deregulation in the patient with chronic pain – the nervous system. It is a fallacy to believe that local invasive interventions advocated by millennium medicine are the best way to achieve this. Additional therapies such as acupuncture, massage and movement reeducation may be added to the program.

How We Diagnose

Jean Pierre Barral, a French osteopathic specialist, developed a technique called listening. Whenever the body struggles with a problem of balance – imbalance, tensions are created. Through training, a pain management specialist trained in osteopathy is able to detect where these abnormal tensions lie in the body. These are the most critical areas that require treatment, as they are usually the source of a problem. The use of this technique is particularly helpful in longstanding problems of chronic pain in which multiple compensatory layers have been created and current symptoms are often far removed from the original source of a patient’s problem. As San Francisco chronic pain doctors and specialists, Drs. Irène and Robert Minkowsky use this technique in their patient evaluation, often helping them unravel difficult cases where a patient has been previously seen by multiple physicians without success.

In their pain management office, the Minkowskys emphasize a thorough comprehensive evaluation that precedes an individualized treatment program with an emphasis on restoration of musculoskeletal balance, control of pain (principally nonpharmacologic) and recovery of function. Their success stems from being eclectic, thorough and methodical in their approach.

Chronic Pain Conditions We Provide Treatment For

  • Back Pain
  • Neck Pain
  • Thoracic Pain
  • Rib Pain
  • Coccydynia
  • Disc Herniation
  • Sciatica
  • Piriformis Syndrome
  • Headache and Migraine
  • TMJ and Facial Pain
  • Neuralgia / Neuropathy
  • Peripheral Joints (shoulder, hip, knee, ankle)
  • Spinal Stenosis and Other Spine Medical Conditions
  • Facet Arthritis
  • Post-Surgical Pain
  • Repetitive Strain Injury
  • Scoliosis
  • Sports Injuries
  • Tendinitis
  • Functional Gastrointestinal and Genitourinary Disorders (heartburn, GE reflux, IBS, Pelvic Pain)